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Puncture Wounds

Topic Overview

Causes of puncture wounds

A
puncture wound is a forceful injury caused by a sharp, pointed object that
penetrates the skin. A puncture wound is usually narrower and deeper than a cut
or scrape. Many people accidentally get puncture wounds with household or work
items, yard tools, or when operating machinery. Most puncture wounds are minor,
and home treatment is usually all that is needed.

Sharp objects,
such as nails, tacks, ice picks, knives, teeth, and needles, can all cause
puncture wounds. Puncture wounds increase your risk of infection because they
are hard to clean and provide a warm, moist place for bacteria to
grow. The bacteria Pseudomonas are a common cause of infections when a puncture wound occurs through the sole of an athletic shoe.

Some punctures are done for
health reasons. For example, a puncture may be used by
a doctor to draw blood or to give fluid or medicines directly into a vein
(intravenous, or IV).

Health professionals
have an increased risk of needle-stick injuries. A puncture from a used needle
increases the risk of infection or for transmitting a blood-borne disease, such
as
hepatitis or
human immunodeficiency virus (HIV). Home treatment may
be all that is needed for puncture wounds from clean needles.

What to do if you get a puncture wound?

When
you have a puncture wound:

Determine if any part of the object that
caused the wound is still in the wound, such as a splinter or
lead (graphite) from a pencil. A pencil
lead puncture wound is less worrisome, so it is not
necessary to check blood levels for lead or worry about lead toxicity or
poisoning.

Determine
if underlying tissues, such as blood vessels, nerves, tendons, ligaments,
bones, joints, or internal organs, have been injured by the
object.

Symptoms of difficulty breathing can range from mild to severe. For example:

You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).

It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

With severe bleeding, any of these may
be true:

Blood is pumping from the wound.

The
bleeding does not stop or slow down with pressure.

Blood is quickly soaking through bandage after bandage.

With moderate bleeding, any of these may
be true:

The bleeding slows or stops with pressure but
starts again if you remove the pressure.

The blood may soak through
a few bandages, but it is not fast or out of control.

With mild bleeding, any of these may be
true:

The bleeding stops on its own or with
pressure.

The bleeding stops or slows to an ooze or trickle after
15 minutes of pressure. It may ooze or trickle for up to 45 minutes.

Certain health conditions and medicines weaken the immune system's ability to fight off infection and
illness. Some examples in adults are:

Diseases such as diabetes, cancer, heart disease,
and HIV/AIDS.

Long-term alcohol and drug
problems.

Steroid medicines, which may be used to treat a variety
of conditions.

Chemotherapy and radiation therapy for
cancer.

Other medicines used to treat autoimmune
disease.

Medicines taken after organ transplant.

Not
having a spleen.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.

Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.

Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

Your age. Babies and older
adults tend to get sicker quicker.

Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.

Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.

Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.

Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.

Pain in adults and older children

Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.

Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.

Symptoms of infection may
include:

Increased pain, swelling, warmth, or redness in or
around the area.

Red streaks leading from the area.

Pus draining from the area.

A fever.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.

Try home treatment to relieve the
symptoms.

Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.

You may need a tetanus shot depending
on how dirty the wound is and how long it has been since your last shot.

For a dirty wound that has
things like dirt, saliva, or feces in it, you may need a shot if:

You haven't had a tetanus shot in the past 5
years.

You don't know when your last shot was.

For a clean wound, you may
need a shot if:

You have not had a tetanus shot in the past 10
years.

You don't know when your last shot was.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and
arrange for care.

If you cannot reach your doctor or you don't have
one, seek care in the next hour.

You do not need to call an
ambulance unless:

You cannot travel safely either by driving
yourself or by having someone else drive you.

You are in an area
where heavy traffic or other problems may slow you down.

Home Treatment

Minor puncture wounds can be
treated effectively at home. If you do not have an increased risk of
infection, you do not have other injuries, and you do not need a tetanus shot or treatment by a
doctor, you can treat a puncture wound at home. Home
treatment can prevent infection and promote healing.

Remove object

Make sure the object causing the wound is not
still in the wound. Check to see if the object is intact and a piece has not
broken off in the wound.

Try to remove the object that caused the
wound if it is small and you can see it. If you have a splinter, try using
cellophane tape before using clean tweezers or a needle. Simply put the tape
over the splinter, then pull the tape off. The splinter usually sticks to the
tape and is removed painlessly and easily. Be careful, and do not push the
object farther into the wound. Do not wet the splinter.

Stop the bleeding

Allow the wound to bleed freely for up to 5
minutes to clean itself out, unless there has been a lot of blood loss or blood
is squirting out of the wound.

After you have stopped the bleeding, check your
symptoms to determine if and when you need to see your
doctor.

Clean the wound

Clean the wound as soon as possible
to reduce the chance of infection, scarring, and tattooing of the skin from
dirt left in the wound. (If dirt or other debris is not removed from a puncture
wound, the new skin will heal over it. The dirt can then be seen through the
skin and may look like a tattoo.)

Wash the wound for 5 minutes with large
amounts of cool water and soap (mild dishwashing soap, such as Ivory, works
well). Some nonprescription products are available for wound
cleaning that numb the area so cleaning doesn't hurt as much. Be sure to read
the product label for correct use.

Do not use rubbing alcohol,
hydrogen peroxide, iodine, or Mercurochrome, which can harm the tissue and slow
healing.

Consider applying a bandage

Most puncture wounds heal
well and don't need a bandage. You may need to protect the puncture wound from
dirt and irritation. Be sure to clean the wound thoroughly before
bandaging it to reduce the risk of infection occurring under the bandage.

Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin

Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow
these safety tips when you use a nonprescription medicine:

Carefully read and follow all
directions on the medicine bottle and box.

Prevention

To prevent puncture wounds, be sure to practice safety when using blunt or sharp objects.

Pay close attention to what you are
doing.

If you become distracted, set the object aside until you can
pay attention to what you are doing.

Know how to use the object
properly.

Have good lighting so you can see what you are
doing.

Wear gloves whenever possible to protect your
hands.

Wear other safety gear, such as glasses or boots, as
appropriate.

Hold a sharp object away from your body while using
it.

Carry the object with the dangerous end away from
you.

Shut the power off and use safety locks on your power tools
when you are not using them.

Be very careful when using
high-pressure equipment, such as staple guns or paint sprayers. Make sure your
work area is clear of people and hazards that could interfere with the safe
operation of the equipment.

This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use.
How this information was developed to help you make better health decisions.